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1 SAN JOAQUIN DELTA COLLEGE PREREQUISITE VERIFICATION INFORMATION LVN TO ASSOCIATE DEGREE IN NURSING PROGRAM - FALL 2009 INFORMATIONAL ONLY KEEP FOR YOUR RECORDS Prerequisite Verification forms for LVN-ADN for fall 2009 admission will be accepted April 20 through April 24, 2009 ONLY and should be submitted to the Health Science Office in Locke Center, Room 213. Mailed packets must be received by the Health Science Division Office no later than 4:45 pm on April 24, A current Application for Admission to San Joaquin Delta College must be on file with the college prior to submitting this Prerequisite Verification. If you've never attended San Joaquin Delta College or have not attended for more than one semester, you must apply ONLINE for admission to the College. Only online applications are accepted and may be completed at the following locations: Electronic Enrollment Services Lab, Stockton Campus, Cunningham 226, at the Tracy Learning Center, 1895 W. Lowell Avenue, Tracy; or by accessing the Delta College web site at ALL fees owed to San Joaquin Delta College must be paid in full before you submit this Prerequisite Verification form and you must be in good standing at San Joaquin Delta College. Official transcripts (in original sealed/unopened envelope) for all lower and upper division courses completed at any and all regionally accredited U.S. institutions other than San Joaquin Delta College must be submitted with this form. Failure to submit transcripts with all grades posted will result in disqualification for fall Course descriptions for prerequisite courses only must accompany the academic transcript for the purpose of determining course equivalency. Course descriptions must come from the specific catalog year in which the course was taken and may be obtained from the college catalog where courses were taken or at Not required for prerequisites taken at San Joaquin Delta College. All required information must be included at the time of submission or your Prerequisite Verification form will be disqualified. The Health Science Division Office will record the date and time upon receipt for all LVN-ADN Prerequisite Verification forms. The date and time will be used in case of ranking percentage ties. All candidates who meet minimum qualifications will be required to take the Test of Essential Academic Skills (TEAS) developed by Assessment Technologies Institute (ATI). A composite/individual adjusted score of 67% is required for program admission. TEAS testing will only be administered on Thursday, June 11 with check-in from 8 8:15 am. Students who have completed the TEAS and have a score of 67% or higher prior to applying, must order an official TEAS transcript at Your official TEAS transcript will be sent electronically and must be received by San Joaquin Delta College no later than 4:45 pm on Friday, April 24, Students are encouraged to thoroughly READ the LVN-ADN Prerequisite Verification Information brochure for details on this enrollment option. Important Notes: Do not staple your materials; please use only paper clips or binder clips. Place your Prerequisite Verification form and all required supporting materials in a 9 x 12 manila envelope. In the upper right hand corner of the envelope, clearly PRINT your Name and Phone Number, along LVN-ADN Prerequisite Verification Packet and submit to the Health Science Division Office, Locke Center, Room 213. Make sure the envelope is no larger than 9 x 12. If you have a change in address or phone number after you submit your Prerequisite Verification form, be sure to keep the Health Science Division informed. You must send an to Judy Lees at Only written request for updates will be accepted. LVN-ADN Prerequisite Verification March 2009, Page 1

2 Required Admission Assessment/Readiness Test Fall 2009 INFORMATIONAL ONLY KEEP FOR YOUR RECORDS The Test of Essential Academic Skills (TEAS ) was developed to measure basic essential skills in the academic content areas of reading, mathematics, science and English and language usage. These skills have been identified as important entry level skills for nursing program applicants. The TEAS is intended for use primarily with adult nursing program applicant populations. The TEAS item format is multiple choice with four response options, one of which is identified as the correct response. The TEAS is approved by the California Community College Chancellor s Office. Who is required to take the TEAS? All candidates who are conditionally admitted and ALL alternates are required to take and pass the TEAS in order to be eligible for enrollment in the Nursing Program. The California Community College Chancellor s Office has established 67% as the composite/adjusted individual total score to pass the TEAS assessment. All candidates who are conditionally admitted AND all alternates must pass the TEAS with a 67% in order to be considered for enrollment in nursing classes for fall How long does the TEAS take? The TEAS takes a total of 209 minutes to complete all four sections of the assessment. Content # of Test Items Amount of Time Reading minutes Mathematics (no calculators permitted) minutes Science minutes English and language usage minutes TOTAL minutes When will the test be administered for fall 2009 admission? Eligible LVN candidates will be given an information sheet including testing procedure, date, time and location. Plan ahead - TEAS test dates for fall 2009 conditionally accepted candidates AND alternates will be on: Thursday, June 11, 2009 Check-in from 8-8:15 am. Individuals who are late will not be admitted to the test. Are there study materials available? Since you must pass the TEAS before you can be officially admitted to the Nursing Program, you are highly encouraged to prepare for this assessment. There are two products available for purchase to help prepare for the TEAS: a Pre-Test Study Manual and Online Practice Assessments. For details, visit online store. In addition, there are several copies of the Pre-Test Study Manual, edition 3.0, in the San Joaquin Delta College library. How much does it cost to take the TEAS? The cost of administering the assessment/readiness test to eligible candidates shall be waived through Spring What score do I need to have on the TEAS to pass? The California Community College Chancellor s Office has established 67% as the composite/adjusted individual total score to pass the TEAS assessment. What happens if I do not receive a composite/adjusted individual total score of 67% on the TEAS? Candidates who are conditionally accepted AND alternates who do not receive a composite/adjusted individual total score of 67% did not receive a passing grade for the entire test. Candidates who are conditionally admitted will be required to successfully complete a remediation plan and a space for the following semester will be held. Alternates who do not pass the TEAS will be removed from the alternate list and will need to reapply for a future semester. If I have taken the TEAS before and earned a composite score of 67% or greater, may I take the assessment again? No, you will not be eligible to retake the assessment at San Joaquin Delta College. I took the TEAS at another college and have a 67% or higher. Is there anything special I need to do? Students who have completed the TEAS and have a score of 67% or higher prior to applying, must order an official TEAS transcript at Your official TEAS transcript will be sent electronically to San Joaquin Delta College. I took the TEAS at San Joaquin Delta College and have a 67% or higher. Is there anything special I need to do? Students who have completed the TEAS at San Joaquin Delta College and passed with a score of 67% or higher prior to applying, only need to indicate this on the Checklist page which is part of the Prerequisite Verification form. LVN-ADN Prerequisite Verification March 2009, Page 2

3 Received by and Date: Time Received: SAN JOAQUIN DELTA COLLEGE PREREQUISITE VERIFICATION FOR LVN TO ASSOCIATE DEGREE IN NURSING PROGRAM - FALL 2009 April 20 through April 24, 2009 Submit this form and all required documentation to: Health Science Division, Locke Center, Room Pacific Avenue Stockton, CA Monday Friday, 7:30 am 4:30 pm Personal Data Please print all information Delta College I.D. 98- Name: Name: Address: Last First Middle Former Home Phone Delta College Copy of current license must be submitted. Cell LVN License Number: Date of Issuance: Date of Expiration: Have you successfully passed the TEAS test with a composite score of at least 67%? Yes No Students who took the TEAS at another college must have an official transcript directly to San Joaquin Delta College and must be received no later than 4:45 pm April 24, Students who took the TEAS at San Joaquin Delta College and passed with a 67% or higher are not required to have an official transcript sent from ATI. Prerequisites - Prerequisite courses completed at other regionally accredited United States colleges or universities must be equivalent to San Joaquin Delta College courses. For determination of course equivalency, official transcripts AND course descriptions for prerequisite courses MUST be submitted with this form. All prerequisite courses must be completed with a grade of C or better and the final grade must be posted to the transcript. For any course in which a grade of C or better was earned, the EARLIEST course grade will be utilized per college policy. Failure to submit transcripts with all grades posted will result in disqualification for fall Prerequisite Courses Human Anatomy BIOL 31 Human Physiology BIOL 32 Microbiology BIOL 22 or 23 Nutrition FCS 6 Written Communications ENG 1A Nursing Synthesis HS 43 College Name (need course description if prerequisite not taken at San Joaquin Delta College) Course Name & Number Semester & Year Completed Grade Please list all regionally accredited United States colleges or universities that you have attended. College/University Name City, State Degree Earned College/University Name City, State Degree Earned LVN-ADN Prerequisite Verification March 2009, Page 3

4 The following information is required for reporting to the Program s governing agencies: Gender: Male Female Age: Ethnicity (circle one) African American American Indian Asian-Pacific Islander Non-Filipino Asian Pacific Islander Filipino Caucasian Hispanic Other Primary Language (circle one) Instructions: Arabic Chinese English Farsi Russian Spanish Tagalog Other, please list Read each option and indicate Option 1 (30-unit option) or Option II (ADN Degree) For Option II only, indicate your choice of admission Sign, date and submit to the Health Science Division Office, Locke 213, with all required documentation. NOTE: No changes are allowed once an admission option has been selected. Admission Options: I have read the LVN to ADN Information Packet and understand each option for admission to the ADN Program. I understand that I may NOT change my admission option once my LVN-ADN Prerequisite Verification form is submitted. Option 1 30 Unit Option I met with the Dean of Health Sciences on Option II Associate Degree Option Date to discuss implications of this option. Enroll in NURS 101 for lecture content of NURS 1 and/or NURS 2, no credit/no grade; enroll in NURS 4 and NURS 5, and all remaining nursing courses (NURS 6, NURS 7, NURS 8, NURS 9 and NURS 10). Waive NURS 6 and NURS 8; enroll in NURS 4 and NURS 5, followed by NURS 7, NURS 9 and NURS 10 only. Progression through program pending space availability for NURS 7, NURS 9, and NURS 10. Enroll in NURS 4 and NURS 5 and all remaining nursing program courses. I understand it will take three semesters to complete the program if I select this option. This option will guarantee the candidate space in each nursing course Printed Name Signature Date Do not staple your materials - use only paper clips or binder clips. Place your Prerequisite Verification form and all required supporting materials in a 9 x 12 manila envelope. In the upper right hand corner of the envelope, clearly PRINT your Name and Phone Number, along LVN-ADN Prerequisite Verification Packet and submit to the Health Science Division Office, Locke Center, Room 213. Make sure the envelope is no larger than 9 x 12. Checklist and Confirmation of Supporting Materials Submitted with this Prerequisite Verification form READ the following carefully and INITIAL each line to verify that each item is complete and/or included with your Prerequisite Verification packet. My Application for Admission to San Joaquin Delta College is current with my correct address. I understand that my LVN-ADN Prerequisite Verification form cannot be processed if I owe fees or am not in good standing with San Joaquin Delta College. I understand that fees owed must be paid before submitting this LVN-ADN Prerequisite Verification form. I understand that ALL CORRESPONDENCE regarding this LVN-ADN Prerequisite Verification form will be sent to my San Joaquin Delta College student address. I understand it is my responsibility to review and respond to in a timely manner and within prescribed timelines. I further understand that failure to review and respond to student within prescribed timelines may result in disqualification from fall LVN-ADN Prerequisite Verification March 2009, Page 4

5 I have made a copy of this form for my records. A copy of my current and valid Vocational Nurse License issued by the State of California or official notification of successful passage of the licensing exam is attached to this Prerequisite Verification form. Checklist and Confirmation of Supporting Materials - continued I understand that once I select an option for admission, I may not make any changes. Only for students who selected to waive NURS 6, Nursing the Childrearing Family and NURS 8, Nursing the Childbearing Family: Documentation of vocational nursing program of at least 60 clinical hours in obstetrics and documentation of at least 60 clinical hours of pediatrics is submitted with this form. The Dean of Health Sciences or designee will determine equivalency of this requirement. Not required for graduates of San Joaquin Delta College Vocational Nursing Program. Assessment/Readiness test Test of Essential Academic Skills (TEAS) Check only one response below College Transcripts: NO, I have NOT taken the TEAS. I understand that if will be required to take and pass the TEAS test with a composite/adjusted individual score of 67% or higher. I understand the TEAS will only be administered on Thursday, June 11, 2009 for fall 2009 admission. YES, I have successfully completed the TEAS with a composite score of 67% of higher. I took the TEAS at San Joaquin Delta College and understand I do not need to have an official transcript sent. I ordered my official TEAS transcript from Assessment Technologies Institute (ATI). I understand that San Joaquin Delta College must receive my official results no later than 4:45 pm on April 24, I have only taken courses at San Joaquin Delta College (SJDC); no official transcript for SJDC coursework is required. I understand that I must submit an official transcript for any and all lower and upper division courses completed at regionally accredited colleges previously attended or currently enrolled in, regardless of applicability to nursing requirements. Failure to declare ALL colleges attended will result in disqualification for fall I am submitting an official transcript (in sealed/unopened envelope) for all lower and upper division courses taken at regionally accredited colleges regardless of whether units were earned or not. List name of school for each official transcript you are submitting: I have attached course descriptions for prerequisite courses taken at other regionally accredited United States colleges, and I understand that course descriptions must come from the specific catalog year in which the course was taken. I acknowledge, by my signature below, that I have READ and UNDERSTAND this entire document. I further acknowledge that all required documents have been submitted with this LVN-ADN Prerequisite Verification form. I understand that missing information will result in disqualification for fall 2009, and I will be unable to submit another LVN-ADN Prerequisite Verification form for this filing period. Printed Name Signature Date LVN-ADN Prerequisite Verification March 2009, Page 5

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